自律:在医患关系中的定位

医疗行为的特殊性，决定了医患双方在医学信息方面的不对称性和医者拥有一定的自由裁量权，因此，医者作为医疗服务的主体，如何增强自律意识，直接关系到诚信的树立及和谐的互动式医患关系的建立和发展。     

3261例老年患者医院感染分析及对策

目的　探讨老年人医院感染状况 ,以采取有效措施降低医院感染率。方法　对我院 3 2 61例老年住院患者进行回顾性调查分析。结果　 3 2 61例中 2 1 2例发生医院感染 ,感染率为 6 .5 % ,以下呼吸道感染为多 ,占 49.5 % ;其次为泌尿道感染 ,占 2 2 .0 % ;胃肠道感染占 1 6 .5 % ;皮肤感染占 6 .6 % ;其他感染占 5 .2 %。结论　老年患者抵抗力低下 ,不合理使用抗生素以及住院时间延长 ,是造成医院感染的主要因素 ,因此应加强老年患者的护理 ,提高其自身防御能力 ,严格加强感染管理制度及医院感染监测 ,合理使用抗生素 ,以有效地降低医院感染的发生。     

TEN YEARS' EXPERIENCE IN LOW VISION PRACTICE

The Low Vision Clinic at the Palmerston North Hospital has now been oerating for 70 years. Over the course of these ten years a number of factors have emerged which can be as readily applied to general ophthalmological practice as to low vision practice. The philosophy of low vision care is one of which all ophthalmologists should be aware and includes factors to be taken into account when dealing with children, people in the workplace, and everyday factors involved in daily living activities, all of which are equally relevant in routine ophthalmological practice. This paper endeavours to share some thoughts on these factors and also discusses means by which the visually handicapped can be helped in areas where specialist low vision services are not readily available.     

Langerhans cell sarcoma in a patient who underwent transplantation

Langerhans cell sarcoma is a rare, aggressive tumour that may metastasize to many organs, likely leading to death of the patient within 1 year. We present the first case described in the literature in a patient who underwent transplantation.     

用视诱发电位和富里叶变换作视力客观估计

目的:研究用图形视觉诱发电位(PVEP)和离散富里叶变换(DFT)作视力客观估计的方法。方法:检测对象为33只正常眼。用翻转频率为10次/秒,条纹张角分别为30、20、18、12、10、6、4和2弧分的垂直方波光栅图形刺激,记录相应的稳态图形视诱发电位。用离散富里叶交换提取WEP频谱中10Hz成分的幅值。以光栅条纹张角为横坐标、相应的VEP频谱幅值为纵坐标作关系曲线,取阈值附近的近似线性部分的数据点作直线回归,用外推法求得阈值和视力。结果:比较VEP所测之视力与用国际标准视力表所测之视力,可见在本研究中70％的受检眼VEP视力估计较准确。结论:用本研究中的VEP技术客观地测量视力可靠性较高。眼科学报1997;13:59～61。     

激光治疗膜性白内障：术前干涉视力测定的意义

应用激光干涉视力仪检测了23例(23只眼)膜性白内障Nd:YAG激光切开术前及术后的干涉视力,结果显示:术前与术后干涉视力之间的差异无显著性(P>0.05)。术前干涉视力与术后矫正视力呈正相关(P<0.05),提示半透明膜性白内障对激光干涉视力无显著影响.激光干涉视力是反映术后视力康复的可靠方法.但在具体分析时,应注意假阴性和假阳性的可能.65.2%的眼术后矫正视力高于术后干涉视力,反映了高度屈光不正的无晶体眼对激光干涉条纹在视网膜上的形成有一定的影响.     

An acute psychiatric rating scale for the clinical assessment of functionally disturbed inpatients

A 28-item behavioral rating scale, the Acute Psychiatric Rating Scale (APRS), was developed using factor-analytic methods for the assessment of functionally disturbed psychiatric inpatients. Fifty-eight staff rated 74 patients on the scale. Seven factorial dimensions were extracted comprising neuroticism, aggression, emotional withdrawal, cognitive impairment, schizophrenia, hypomania and self-injuriousness. The scale was evaluated in 4 different psychiatric inpatient units: two acute admission wards, an intensive care unit and a regional secure unit. Behavioral ratings on the scale were related to several patient demographic and treatment variables, including age, sex, marital status, legal status, length of admission and electroconvulsive therapy. The scale was found to possess a clear factorial structure, good interrater reliability and promising clinical validity for further research use in psychiatric inpatient settings.     

Intracranial actinomycosis in juvenile patients Case report and review of the literature

A case of actinomycotic brain infection in a juvenile patient is described. Cases of actinomycosis affecting the head and neck are rare, particularly in juvenile patients. In this case complete resolution of the infection was achieved by means of surgical treatment and prolonged antibiotic therapy. The authors emphasize the importance of a combined approach for treatment of this unusual brain infection and stress the difficulties involved in the diagnosis of this pathology. Received: 3 November 1997     

高电压胸部摄影诊断和防护效果研究

作者以体模实验为基础。测定了不同管电压拍摄胸片时的病人剂量，考察了提高管电压对胶片影像质量的影响，结果表明，使用高电压拍摄胸片比使用低电压有利于降低病人剂量，在增加影像信息量，提高肋骨阴影区和纵膈区灶检出率方面更有较大优越性，此外，使用高电压技术不家利于延长Ｘ射线管的使用寿命。